Trial reportInternational urogynecology journal2013
Spontaneous pushing to prevent postpartum urinary incontinence: a randomized, controlled trial.
Trial report in International urogynecology journal, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
13 citing papers in PubMed, 5 syntheses or guidelines pooled it, 37 citations in OpenAlex.
- Effectiveness of breathing exercise on the duration of labour: A systematic review and meta-analysis.Journal of global health · 2023Pooled it
- Postpartum urinary incontinence and birth outcomes as a result of the pushing technique: a systematic review and meta-analysis.International urogynecology journal · 2022Pooled it
- Effectiveness of electrical stimulation combined with pelvic floor muscle training on postpartum urinary incontinence.Medicine · 2019Pooled it
- Perineal techniques during the second stage of labour for reducing perineal trauma.The Cochrane database of systematic reviews · 2017Pooled it
- Pushing/bearing down methods for the second stage of labour.The Cochrane database of systematic reviews · 2017Pooled it
- Does the type of pushing at delivery influence pelvic floor function at 2 months postpartum? A pragmatic randomized trial-The EOLE study.Acta obstetricia et gynecologica Scandinavica · 2023Trial
- Trial
- Midwives' Perspectives on a Program Supporting Spontaneous Pushing During the Second Stage of Labor: A Qualitative Study.Birth (Berkeley, Calif.) · 2026Article
- Not Just Mechanical Birthing Bodies: Birthing Consciousness and Birth Reflexes.The Journal of perinatal education · 2023Article
- Women's Knowledge of Bladder Health: What We Have Learned in the Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium.Current bladder dysfunction reports · 2022Article
- Preventing urinary incontinence during pregnancy and postpartum: a review.International urogynecology journal · 2013Review
- Midwives' verbal support of nulliparous women in second-stage labor.Journal of obstetric, gynecologic, and neonatal nursing : JOGNNArticle
- The role of maternity care providers in promoting shared decision making regarding birthing positions during the second stage of labor.Journal of midwifery & women's healthArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
introduction and hypothesisThe risk for urinary incontinence can be 2.6-fold greater in women after pregnancy and childbirth compared with their never-pregnant counterparts, with the incidence increasing with parity. We tested the hypothesis that the incidence of de novo postpartum urinary incontinence in primiparous women is reduced with the use of spontaneous pushing alone or in combination with perineal massage compared with women who experienced traditional directed pushing for second-stage management.
methodsThis was a prospective clinical trial enrolling and randomizing 249 women into a four-group design: (1) routine care with coached or directed pushing, (2) spontaneous self-directed pushing, (3) prenatal perineal massage initiated in the third trimester, and (4) the combination of spontaneous pushing plus perineal massage. Self-report of incontinence was assessed using analysis of variance (ANOVA) and covariance (ANCOVA) models in 145 remaining women at 12 months postpartum using the Leakage Index, which is sensitive to minor leakage.
resultsNo statistical difference in the incidence of de novo postpartum incontinence was found based on method of pushing (spontaneous/directed) (P value = 0.57) or in combination with prenatal perineal massage (P value = 0.57). Fidelity to pushing treatment of type was assessed and between-groups crossover detected.
conclusionsSpontaneous pushing did not reduce the incidence of postpartum incontinence experienced by women 1 year after their first birth due to high cross-over between randomization groups.
Indexed as
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.